Guide · First aid

Using a tourniquet

A tourniquet is a last resort for life-threatening bleeding from an arm or leg that firm direct pressure cannot control, or when you cannot reach the wound to press on it. Call your local emergency number (112 in Europe and many other countries, 911 in North America) straight away. Try firm direct pressure first, as described in the guide to stopping heavy bleeding.

When to use one

• Blood is spurting or pouring from a limb and pressure isn't stopping it.
• A limb has been crushed or torn off.
• You have several casualties, or need your hands free to keep yourself or others safe.

Never use a tourniquet on the neck, head or body. For wounds there, keep pressing hard and pack deep wounds with cloth.

Applying a commercial tourniquet

1. Place it on bare skin if you can, 5–7 cm above the wound — between the wound and the heart.
2. Don't place it over a joint such as the knee or elbow. If the wound is just below a joint, put the tourniquet above that joint.
3. Pull the strap as tight as you can and fasten it.
4. Twist the rod (the windlass) until the bleeding stops. This will take more turns than you expect.
5. Lock the rod in its clip so it can't unwind.
6. Write the time it was applied on the tourniquet or the person's forehead.

Improvising one

A commercial tourniquet works much better, so carry one if you can. If you must improvise:

1. Use a strip of strong cloth at least 4 cm wide, such as a folded triangular bandage. Never use wire, string, a cable tie or a thin cord — they cut into the skin and don't compress properly.
2. Tie it around the limb 5–7 cm above the wound with a half knot.
3. Lay a strong stick or similar rod on the knot and tie a full knot over it.
4. Twist the stick until the bleeding stops, then tie or tape it in place.

Afterwards

• Applied properly, a tourniquet hurts. That is normal — don't loosen it because of pain.
• Never loosen or remove it. Only medical staff should do that.
• If bleeding continues after tightening as far as you can, put a second tourniquet just above the first.
• Leave it visible. Don't cover it with clothing or blankets.
• Keep the person lying down and warm, and watch for shock.
• Make sure every rescuer knows a tourniquet is on and when it went on.

A tourniquet left in place for several hours can damage the limb, but it is far better to save a life. Get the person to hospital as fast as you safely can.

This guide does not replace a first-aid course. A few hours of hands-on practice will make you far more confident when it matters.

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